Evaluation of the UCSF cancer of the prostate risk assessment for prediction of biochemical recurrence (CAPRA) to predict which patients need dose escalation in intermediate-risk disease.
Bibliographic record
Abstract
54 Background: The University of California, San Francisco (UCSF) Cancer of the Prostate Risk Assessment (CAPRA) is a validated preoperative index which predicts recurrence free survival and the risk of adverse pathological features after prostatectomy. We analyzed the value of the CAPRA score to predict which patients might benefit from dose escalation in a randomized dose-escalation trial for intermediate risk patients. Methods: We analyzed 119 patients with intermediate risk prostate cancer (Gleason ≤ 6 and PSA 10-20 or Gleason 7 and PSA <10). Patients were randomized between external beam radiotherapy (EBRT) doses of either 70.2 Gy or 79.2 Gy (1.8 Gy per day). All patients had a follow up of at least 2 years. Biochemical failure (BF) was defined with the Phoenix definition. Difference between CAPRA groups was calculated using Kaplan-Meier method. Results: Twenty percent (24/119) had BF. Median time to BF was 60.5 months (1-102) and median follow up for patients without failure was 66 months (25-102). A CAPRA score of 0-2 (risk of recurrence 5y post prostatectomy <10%) was present in 16%, a score of 3-5 (5y risk 18-26%) in 72% and CAPRA 6 (5y risk 37%) in 12%. Stratified according to the 3 CAPRA groups 0%, 20% and 50% ofpatients had a recurrence. The difference between the 3 groups was significant (p=0.019). When stratified according to treatment arm, differences remained significant (p=0.025). None of the patients with a CAPRA 0-2 had biochemical recurrence, even with 70.2 Gy only. When analyzing only patients with a CAPRA score of 3-5, patients in the treatment arm with 79.2 Gy, had less BF with 15% compared to 26% in the arm with 70.2 Gy (p=0.187). The 2 survival curves start to split at 5y of follow-up. Conclusions: The CAPRA score seems to be a promising, clinically easily applicable tool to predict for patients who might benefit from dose escalation. Patients with a CAPRA score of 0-2 do not seem to benefit from dose escalation, but there is a trend for a benefit in patients with a CAPRA 3-5. Clinical trial information: NCT00033631.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".